Letters to the Editor

Tinidazole for Treatment of Trichomonas Vaginalis


Am Fam Physician. 2005 Oct 15;72(8).

to the editor: Drs. Owen and Clenney presented a nicely organized review of the management of vaginitis in their American Family Physician article.1 They mention tinidazole (Tindamax) for the treatment of Trichomonas vaginalis. This drug has been approved by the U.S. Food and Drug Administration and is now available in the United States for the treatment of T. vaginalis. It is given in a single 2-g oral dose, similar to metronidazole (Flagyl), both of which interact with alcohol. Side effects of the two drugs are similar. Tinidazole is pregnancy category C and is contraindicated in women who are in the first trimester. Metronidazole is pregnancy category B. Tinidazole is considerably more expensive than generic metronidazole but may be effective in patients with metronidazole-resistant Trichomonas.2

In the discussion of diagnostic criteria for bacterial vaginosis, the authors1 correctly quote the Amsel criteria. The presence of a fishy odor would certainly be a positive whiff test, but the traditional way to do the whiff test is to check for a fishy odor after adding a few drops of 10 percent potassium hydroxide to the vaginal secretions.3 This raises the pH and causes a release of aromatic amines by the anaerobes, resulting in a distinctive amine, or fishy odor, that may not be evident on initial examination.


1. Owen MK, Clenney TL. Management of vaginitis. Am Fam Physician 2004;70:2125-32.

2. Tinidazole (Tindamax)—a new anti-protozoal drug. Med Lett Drugs Ther 2004;46:70-2.

3. Eschenbach DA, Hillier S, Critchlow C, Stevens C, DeRouen T, Holmes KK. Diagnosis and clinical manifestations of bacterial vaginosis. Am J Obstet Gynecol 1988;158:819-28.

Send letters to afplet@aafp.org, or 11400 Tomahawk Creek Pkwy., Leawood, KS 66211-2680. Include your complete address, e-mail address, and telephone number. Letters should be fewer than 400 words and limited to six references, one table or figure, and three authors.

Letters submitted for publication in AFP must not be submitted to any other publication. Possible conflicts of interest must be disclosed at time of submission. Submission of a letter will be construed as granting the AAFP permission to publish the letter in any of its publications in any form. The editors may edit letters to meet style and space requirements.

This series is coordinated by Kenny Lin, MD, MPH, Associate Deputy Editor for AFP Online.



Copyright © 2005 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact afpserv@aafp.org for copyright questions and/or permission requests.

Want to use this article elsewhere? Get Permissions


May 2022

Access the latest issue of American Family Physician

Read the Issue

Email Alerts

Don't miss a single issue. Sign up for the free AFP email table of contents.

Sign Up Now

Navigate this Article